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WO1993022981A1 - Procede et appareil pour simplifier l'arthroplastie totale de la hanche - Google Patents

Procede et appareil pour simplifier l'arthroplastie totale de la hanche Download PDF

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Publication number
WO1993022981A1
WO1993022981A1 PCT/US1993/004595 US9304595W WO9322981A1 WO 1993022981 A1 WO1993022981 A1 WO 1993022981A1 US 9304595 W US9304595 W US 9304595W WO 9322981 A1 WO9322981 A1 WO 9322981A1
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WO
WIPO (PCT)
Prior art keywords
femur
cable
attachment
length
supporting axis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US1993/004595
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English (en)
Inventor
Gail M. Benson
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
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Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to JP6503765A priority Critical patent/JPH08508652A/ja
Priority to EP93913891A priority patent/EP0676932A4/fr
Publication of WO1993022981A1 publication Critical patent/WO1993022981A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4684—Trial or dummy prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/14—Surgical saws
    • A61B17/15—Guides therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/76—Means for assembling, fitting or testing prostheses, e.g. for measuring or balancing, e.g. alignment means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/365—Connections of heads to necks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4658—Measuring instruments used for implanting artificial joints for measuring dimensions, e.g. length
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
    • Y10S623/912—Method or apparatus for measuring or testing prosthetic
    • Y10S623/914—Bone

Definitions

  • the present invention relates to a method and apparatus for facilitating the total hip arthroplasty procedure in which both an acetabular cup prosthesis and a femoral implant prosthesis are installed or in a partial hip arthroplasty where one of the components of an earlier arthroplasty are replaced and particularly, to a method and apparatus for assuring that the resulting leg length of the patient is optimized.
  • Femoral implants are available in a variety of lengths and cross-section to fit the shape of the reamed-out femoral canal and are also provided with an angularly disposed femoral neck and spherical head that extend at an angle to the stem to orient the replacement head in the acetabular cup prosthesis.
  • the acetabular cup prosthesis is itself installed in the patient's reamed-out acetabulum. After both components are installed, the spherical head is inserted into the cup and the muscles and tendons that were separated or severed in the surgical exposure are reattached to hold the leg in place. Numerous articles have been published describing and illustrating total hip arthroplasty procedures employing a wide variety of total hip joint prostheses.
  • a common problem that arises in completing the total hip arthroplasty procedure involves the selection of the appropriate length neck of the femoral implant so that after the procedure is completed, the patient enjoys a normal or enhanced leg length. If only one of the patient's legs is operated on, it is naturally desirable to ensure that the patient's legs are of approximately the same length after recovery from the surgery. Often, due to deterioration in the hip joint, the leg may initially be shorter than desired and the replacement surgery should include restoration of nearly equal leg length. When both hip joints are placed, it may be desirable to equalize and lengthen both legs.
  • leg length arise from the difference in sizes of the femoral implants, the depth of insertion of the acetabular cup, and the length of the reducted femoral neck.
  • surgeon simply changes the length of the femoral neck that is used. Once the acetabular cup is in place, it is rarely changed.
  • Some methods have involved measuring the distance from the palpable iliac crest near the waist line to the greater trochanter on the outside of the proximal femur, both of these markers are quite distant from the true hip joint and only indirectly attempt to measure length.
  • the invention relates in one aspect to a surgical hip replacement procedure that is particularly adapted for exactly controlling in a predetermined manner the length of the leg that will result.
  • the invention relates to an apparatus, which may be in kit form, for performing the surgical procedure.
  • the procedure involves: preoperatively measuring the patient's legs and noting any disparity in length; surgically exposing the superior portion of the femur and the acetabular region of the iliac bone; marking or forming an attachment to a fixed position on the iliac bone, e.g., the superior eminence of the acetabulum; marking or forming an attachment to the femur approximately at the level of the lesser trochanter such that a straight line drawn between said marks or attachments is approximately parallel to and closely spaced from the weight supporting axis of the femur (that is, a line that connects that connects the center of rotation of the femoral ball and that passes through the center of the knee), noting the distance between said marks or attachments when the femur is held in a normal extended position; performing the surgical task of implanting an acetabular cup prosthesis and a trial proximal femoral prosthesis having a head received in the cup; noting the distance between the marks or attachments to determine whether the
  • the invention in another aspect, involves a calibration apparatus comprising a first attachment attachable to the superior eminence of the acetabulum, a second attachment attachable to the femur at approximately the level of the lesser trochanter, and a cable having one end adapted to be attached to one of said attachments and with its other end extending toward the other attachment, the cable including means for noting on the cable the point representing the position of the other of the two attachments.
  • the cable has a free end that is attachable to one of said attachments, the cable including scale means carried by and movable longitudinally of the cable, the scale means including indicia that can be positioned at the location of said other attachment, and fixation means for fixing the scale at a desired position along the length of said cable.
  • the cable has at its other end means for attaching it to other objects, such as a surgical drape, to hold the cable out of the way during the surgical procedure.
  • Figure 1 is a posterior view of the right pelvic girdle and a portion of the right leg bones
  • Figure 2 is an illustration of a femoral implant of a type employing a separate head adapted to fit in an acetabular cup of a total hip joint replacement prosthesis;
  • Figure 3 is an illustration of a first embodiment of the calibration apparatus employed in the practice of the method of the present invention;
  • Figure 4 is an illustration of the use of the calibration apparatus of Figure 3 in initially measuring the distance between two points on the iliac bone and the femur in a posterior surgical approach;
  • Figure 5 is an illustration of the use of the calibration apparatus of Figure 3 in selecting the appropriately sized femoral implant in accordance with the method of the present invention practiced in a posterior surgical approach;
  • FIG. 6 is an illustration of an alternative calibration apparatus employed in the practice of the method of the present invention.
  • FIG. 1 illustrates a posterior view of the right pelvic girdle and a portion of the right leg showing the normal alignment of a human hip joint in relation to the knee joint.
  • the femur 10, or thigh bone articulates at its proximal end with the iliac bone 12. Its distal end articulates with the tibia at the knee joint 14.
  • the shaft of the femur bows medially so that it approaches the femur of the opposite thigh.
  • the knee joints are brought together to the body's line of gravity or weight supporting axis.
  • the proximal end of the femur 10 comprises the rounded head 16 that articulates with the acetabulum 18 of the iliac bone 12.
  • the neck 20 of the femur 10 is a constricted region distal to the head 16. A fairly common fracture in the elderly occurs at the neck 20. Apparently the neck 20 becomes so weak that it fails to support the body.
  • the greater trochanter 22 and lesser trochanter 24 are projections on the femur 10 that serve as points of attachment for some of the thigh and buttock muscles. Between the trochanters on the anterior surface is a narrow introchanteric line. Between the trochanters on the posterior surface is an intertrochanteric crest.
  • the shaft of the femur contains a rough vertical ridge on its posterior surface called the linea aspera. This ridge serves for the attachment of several thigh muscles.
  • the distal end of the femur is expanded and includes the medial condyle and the lateral condyle. These articulate with the tibia and (with attendant ligaments, etc.) from the knee joint 14.
  • the weight of the body is borne by the normal pelvic girdle and lower extremities in conjunction with the associated muscles and ligaments in a weight supporting axis extending generally through the superior aspect of the acetabulum 18 inferiorly alongside the femur and through the center of the knee joint 14 generally as illustrated by broken line 26 in Figure 1.
  • the weight supporting axis 26 passes through or adjacent to a line draw in between the superior eminence 28 of the acetabulum and the lesser trochanter 24.
  • the hip joint may become less mobile, painful or totally unusable, requiring surgical intervention and a total hip arthroplasty employing a hip joint prosthesis of the type described in the above-referenced publications.
  • a wide variety of prostheses are available from several manufacturers, the prostheses typically including a metal acetabular cup for surgical replacement of the natural acetabulum 18, a high density polyethylene cup liner positioned within the cup prosthesis and a femoral implant comprising a femoral stem and a femoral ball-shaped head of the type illustrated in Figure 2.
  • FIG 2 it illustrates a typical femoral implant stem 31 and femoral implant head 33 which are attached together to form the femoral implant 29.
  • the femoral stem 31 is available in a number of cross-section shapes, sizes and lengths having varying exterior contours, neck offsets and neck lengths.
  • the femoral implant head 33 is usually a highly polished, spherical metal ball provided in a number of available diameters and neck lengths and provided with a Morse taper female receptacle for receiving the Morse tapered neck 35 of a stem 31.
  • manufacturers of total hip prostheses provide a selection of different neck length femoral implant stems 31 and femoral implant heads 33. Thus, it is possible to customize the overall neck length as necessary to replicate the proper leg length for the individual patient.
  • the operative procedure may be simplified and the need to reoperate substantially eliminated by providing a calibrated measurement between respective fixed points of the iliac bone and femur along the weight supporting axis 26 prior to dislocating the femoral head 16 from the acetabulum 18 and employing the calibrated distance, adjusted positively or negatively if the leg operated on is shorter or longer than the patient's other leg in positioning the resected femur in relation to the acetabular cup prosthesis for sizing the length of the neck of the femoral stem of the femoral implant.
  • Figure 3 illustrates a calibration apparatus 30 comprising length of cable 34 and a bone nail 32 that are used as illustrated in Figures 4 and 5 to select a properly sized femoral stem 31 and head 33 during the procedure and avoid reoperation.
  • the calibration apparatus depicted in Figure 3 comprises a length of stranded wire cable 34 extending between an alligator clip 36 and a loop 38 formed by bending the cable 34 back against itself and crimping a crimp tube 40 around both to form a loop.
  • the loop 38 is formed after the bone nail 32 is fixed in the region of the superior eminence 28 of acetabulum 18 as shown in Figure 4.
  • the alligator clip 36 is provided so that the free end of the cable 34 may be attached to a surgical drape to hold the apparatus 30 out of the surgical field when it is not used in the manner depicted in Figures 4 and 5.
  • the calibration apparatus 30 depicted in Figures 3-5 also includes a slideable tube 42 having four calibration marks 44 spaced apart about one centimeter in the outer surface of the tube 42.
  • the calibration tube 42 may be slid back and forth on the length of stranded wire cable 34 so that one of the marks 44 is aligned with a mark or attachment, e.g., another bone nail 32, made on the femur 10 and crimped in place by a crimping tool.
  • Figure 4 it illustrates the placement of the calibration apparatus 30 to effect a calibrated measurement of distance along the weight supporting axis 26 between the femur 10 and the iliac bone 12 before the head 16 is dislocated from the acetabulum 18. It will be understood that for the sake of simplicity, the operating field, including the incision and the separation of the muscles and ligaments, are not illustrated in Figures 4 and 5.
  • the surgical nail 32 is driven into the region of the superior eminence 28 of the acetabulum 18 about 2 centimeters above the acetabular rim in the 11 o'clock position after the loop 38 in the cable 34 has been mechanically attached to the head of the nail 32. Thereafter, the cable 34 is extended in the direction of the weight supporting axis 26 bringing it alongside the lesser trochanter 24.
  • the slideable calibration tube 42 is moved along the length of cable 34 until one of its indicia 44 is aligned with a mark 46 made on the lesser trochanter 24.
  • the mark 46 may in fact be a further surgical nail driven into the bony protruberance of the lesser trochanter 24 since it is difficult to otherwise mark the bone.
  • the tube 42 is crimped tightly against the stranded wire cable 34 so that it cannot be moved or dislodged.
  • the selected indicia 44 is noted in the surgical record and the cable 34 is pivoted superiorly out of the operating field.
  • the alligator clip 36 is attached to a surgical drape covering the patient's torso in order to keep the apparatus 30 out of the surgical field to allow the surgeon to dislocate the head 16 from the acetabulum 18 and proceed with the resection of the femur and the surgical placement of the acetabular cup prosthesis and the reaming of the femoral canal to accept the trial femoral components in the manner described in the above-incorporated publications.
  • Figure 5 it illustrates the placement of an artificial acetabular cup prosthesis 50 in the location of the acetabulum 18 and the insertion of a trial femoral implant 29 comprising the femoral implant stem 31 and femoral implant head 33 in relation to the acetabular cup prosthesis 50 and the femoral canal 52 outlined in the resected femur 10.
  • a trial femoral implant 29 is inserted as shown in Figure 5 to test the fit and the articulation of the leg.
  • the failure to select the proper neck length of the femoral implant 29 may cause the patient to suffer from an imbalance in the resulting leg length.
  • the calibration apparatus 30 is employed in the trial fitting stage to ensure that the selected neck length results in the desired leg length.
  • the stranded wire cable 34 is extended in the direction of the weight supporting axis 26 to determine whether or not the calibration indicia 44 previously aligned to the mark or nail 46 is again aligned. If the measurement indicates that the actual position is superior or inferior to the noted calibration indicia 44, then the trial femoral implant 29 is withdrawn and/or longer or shorter necked components are substituted. The process is repeated until the calibration indicia is aligned as closely as possible to the femoral mark or nail.
  • the lengthened or shortened amount may be taken into account when the calibration mark 44 is noted as described and illustrated in respect to Figure 4.
  • FIG 6 it illustrates an alternate embodiment of the calibration tool 30 employing the bone nail 32 and a length of ball or key chain 35 having an eyelet loop 37 on one end of the length of chain 35.
  • the eyelet loop 37 is attached to the head of the bone nail 32 which is nailed into the iliac bone 12 in the region of the superior eminence 28 of the acetabulum 18 as described in conjunction with Figure 4.
  • the chain 35 is stretched inferiorly in the direction of the weight supporting axis 26 alongside the lesser trochanter 24 and a metal clip 43 is crimped between adjacent balls of the ball chain 35 at the point where it aligns with the mark or nail 46.
  • the tool 31 is used in conjunction with the sizing of the femoral implant components in the same fashion as is described in respect to Figure 5 and thereafter removed.
  • the procedure described above involves a posterior surgical exposure of the hip joint.
  • the procedure may be used in an anterior surgical approach.
  • the mark or nail 46 may be made or inserted in the anterior-medial cortex at the level of the lesser trochanter.
  • the nail 32 is advantageously inserted about 2 centimeters above the acetabular rim in the one o'clock position.
  • the cable 34 or chain 35 is extended therebetween as described above but along the anterior side of the neck of the femur and in line with the weight-bearing axis. Selection of the anterior or the posterior approach is left to the discretion of the surgeon.
  • the invention has been described in detail with particular reference to the preferred embodiments thereof, but it will be understood that variations and modifications can be effected within the spirit and scope of the invention.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Biophysics (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Abstract

Procédé et appareil (30) à utiliser dans les interventions chirurgicales de remplacement de la hanche pour s'assurer que les composants de l'articulation de la prothèse de hanche sont d'une taille appropriée afin que la longueur de la jambe du patient, après l'intervention soit correcte. Lors de l'intervention, lorsque l'acétabulum (18) et le fémur (10) sont mis à nu, on fixe à l'éminence supérieure (28) de l'acétabulum (18) une extrémité d'un câble de mesure souple (34) qui est étiré en partie inférieure de manière à s'aligner sur un point précis du fémur (10), de préférence le petit trochanter (24). Le point sélectionné sur le fémur (10) est positionné par rapport au câble. Une fois déterminée la distance de référence entre les points fixes sur l'acétabulum (28) et le fémur (10), le câble souple (34) est écarté tandis que son extrémité demeure fixée à l'acétabulum (28). Ensuite, l'intervention de l'arthroplastie totale de la hanche se poursuit de la manière habituelle.
PCT/US1993/004595 1992-05-14 1993-05-14 Procede et appareil pour simplifier l'arthroplastie totale de la hanche Ceased WO1993022981A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
JP6503765A JPH08508652A (ja) 1992-05-14 1993-05-14 全体の股関節部形成を簡易化するための方法及び装置
EP93913891A EP0676932A4 (fr) 1992-05-14 1993-05-14 Procede et appareil pour simplifier l'arthroplastie totale de la hanche.

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US07/882,938 1992-05-14
US07/882,938 US5318571A (en) 1992-05-14 1992-05-14 Method and apparatus for simplifying total hip arthroplasty

Publications (1)

Publication Number Publication Date
WO1993022981A1 true WO1993022981A1 (fr) 1993-11-25

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1993/004595 Ceased WO1993022981A1 (fr) 1992-05-14 1993-05-14 Procede et appareil pour simplifier l'arthroplastie totale de la hanche

Country Status (5)

Country Link
US (3) US5318571A (fr)
EP (1) EP0676932A4 (fr)
JP (1) JPH08508652A (fr)
CA (1) CA2135753A1 (fr)
WO (1) WO1993022981A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994012109A1 (fr) * 1992-11-26 1994-06-09 Gustaf Gadelius Dispositif permettant de definir avec surete le positionnement reciproque du femur et de l'os iliaque en arthroplastie de la hanche
CN111189372A (zh) * 2020-03-05 2020-05-22 陕西斯坦特生物科技有限公司 股骨柄偏摆角目测检具及其检测方法

Families Citing this family (41)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5814050A (en) * 1992-05-14 1998-09-29 Bentwood Place, Inc. Hip offset-inset apparatus and method
US5423828A (en) * 1992-05-14 1995-06-13 Bentwood Place, Inc. Method and apparatus for simplifying prosthetic joint replacements
US5318571A (en) * 1992-05-14 1994-06-07 Benson Gail M Method and apparatus for simplifying total hip arthroplasty
CA2165980C (fr) * 1993-06-21 2001-02-20 Mark Nicholas Dance Methode et appareil pour localiser les structures fonctionnelles de la partie inferieure de la jambe pendant la chirurgie du genou
US5345986A (en) * 1993-12-09 1994-09-13 Kieffer Vincent C Auxiliary router guide
US5700268A (en) * 1997-01-06 1997-12-23 Zimmer, Inc. Device for measuring leg length and off-set for a total hip replacement
US5937530A (en) * 1997-11-26 1999-08-17 Masson; Martin Kinematic restraint device and method for determining the range of motion of a total knee replacement system
US6162253A (en) * 1997-12-31 2000-12-19 Iowa State University Research Foundation, Inc. Total elbow arthroplasty system
US6193724B1 (en) * 1998-11-25 2001-02-27 Kwan-Ho Chan Apparatus and method for determining the relative position of bones during surgery
US6306171B1 (en) 1998-12-09 2001-10-23 Iowa State University Research Foundation, Inc. Total elbow arthroplasty system
US6302890B1 (en) * 2000-03-16 2001-10-16 Leone Innovations Corporation Pelvic alignment assembly
US6623488B1 (en) * 2000-03-16 2003-09-23 Leone Innovations Corporation Pelvic alignment assembly
US20020120340A1 (en) 2001-02-23 2002-08-29 Metzger Robert G. Knee joint prosthesis
US7001346B2 (en) 2001-11-14 2006-02-21 Michael R. White Apparatus and methods for making intraoperative orthopedic measurements
US20050119697A1 (en) * 2001-11-21 2005-06-02 Minnesota Scientific, Inc. Method of table mounted retraction in hip surgery
US20070093696A1 (en) * 2001-11-21 2007-04-26 The LeVahn Intellectual Property Holding Company, LLC Method of table mounted retraction in hip surgery and surgical retractor
US6695883B2 (en) * 2002-04-11 2004-02-24 Theodore W. Crofford Femoral neck fixation prosthesis
JP2003339719A (ja) * 2002-05-30 2003-12-02 Pentax Corp 内視鏡用クリップ装置
US7905924B2 (en) * 2003-09-03 2011-03-15 Ralph Richard White Extracapsular surgical procedure
CN1316947C (zh) * 2004-10-23 2007-05-23 温中一 人工髂骨缺损重建装置
US20070021644A1 (en) * 2005-03-02 2007-01-25 Woolson Steven T Noninvasive methods, apparatus, kits, and systems for intraoperative position and length determination
US7575575B2 (en) * 2005-03-18 2009-08-18 Ron Anthon Olsen Adjustable splint for osteosynthesis with modular components
US20060229605A1 (en) * 2005-03-18 2006-10-12 Olsen Ron A Adjustable splint for osteosynthesis with incrementing assembly for adjustment in predetermined increments
JP4507097B2 (ja) * 2005-03-24 2010-07-21 国立大学法人大阪大学 形態評価と機能評価の最適バランスに基づくインプラント三次元手術計画システム
CA2607036C (fr) 2005-06-02 2013-07-23 Orthosoft Inc. Alignement de la jambe pour la mesure de parametres chirurgicaux en vue de la mise en place d'une prothese de la hanche
USD577439S1 (en) 2005-06-03 2008-09-23 Ortho Innovations, Llc Surgical nail
US7731738B2 (en) * 2005-12-09 2010-06-08 Orthopro, Llc Cannulated screw
US8562616B2 (en) 2007-10-10 2013-10-22 Biomet Manufacturing, Llc Knee joint prosthesis system and method for implantation
US8163028B2 (en) 2007-01-10 2012-04-24 Biomet Manufacturing Corp. Knee joint prosthesis system and method for implantation
US8328873B2 (en) 2007-01-10 2012-12-11 Biomet Manufacturing Corp. Knee joint prosthesis system and method for implantation
US8187280B2 (en) 2007-10-10 2012-05-29 Biomet Manufacturing Corp. Knee joint prosthesis system and method for implantation
EP2104474B1 (fr) 2007-01-10 2012-08-29 Biomet Manufacturing Corp. Système de prothèse d'articulation de genou
US8801799B2 (en) * 2008-07-24 2014-08-12 Howmedica Osteonics Corp. Femoral head prosthesis
US8075629B2 (en) * 2008-12-18 2011-12-13 Depuy Products, Inc. Orthopaedic prosthesis having a seating indicator
US8403995B2 (en) * 2008-12-18 2013-03-26 Depuy Products, Inc. Device and method for determining proper seating of an orthopaedic prosthesis
RU2410053C1 (ru) * 2009-11-16 2011-01-27 Федеральное государственное учреждение "Российский научный центр "Восстановительная травматология и ортопедия" имени академика Г.А. Илизарова Федерального агентства по высокотехнологичной медицинской помощи" Способ моделирования большого вертела при эндопротезировании тазобедренного сустава
CA2945799C (fr) * 2014-04-14 2020-06-02 Mohamed R. Mahfouz Alignement cinematique et nouvelles protheses femorales et tibiales
JP6490683B2 (ja) 2014-06-19 2019-03-27 京セラ株式会社 関節手術用測定器具
US10123883B2 (en) 2015-07-22 2018-11-13 Karl Baird Length/offset reproducing device for total hip arthroplasty
CN112971981B (zh) * 2021-03-02 2022-02-08 北京长木谷医疗科技有限公司 基于深度学习的全髋关节图像处理方法和设备
CN113332008B (zh) * 2021-05-24 2022-09-20 汕头大学 一种髋关节置换术中股骨长度的确定方法及系统

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4782842A (en) * 1987-02-02 1988-11-08 Fietti Jr Vincent G Arcuate fixator
US4988349A (en) * 1987-01-21 1991-01-29 Orthofix S.R.L. Device for osteosynthesis
US5122145A (en) * 1990-11-09 1992-06-16 Fishbane Bruce M Measuring device for use in total hip replacement

Family Cites Families (25)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2355585A (en) * 1941-08-08 1944-08-08 Dietzgen Co Eugene Beam compass
US2353291A (en) * 1943-08-28 1944-07-11 Bernard I Blickman Method and means for producing simulated stocking seams
US2621409A (en) * 1950-09-12 1952-12-16 William F Dvorak Compass device
US2752683A (en) * 1952-10-16 1956-07-03 Howard B Crane Beam compass
US2756507A (en) * 1955-05-03 1956-07-31 Murdo L Martin Measuring device for bolt or roll goods
US3002280A (en) * 1958-02-14 1961-10-03 Jr Albert D Bennett Beam compass
GB1043039A (en) * 1965-08-23 1966-09-21 Monty Grant Improved measuring device
US3392449A (en) * 1967-04-27 1968-07-16 Francis V. Tierney Instant marker
US3639995A (en) * 1970-01-14 1972-02-08 Irving Gardner Device for measuring the ring size of a finger
US3643651A (en) * 1970-08-04 1972-02-22 Lorton Lab Ltd Finger scale for gynecologic and other measurement of body orifice
US4279260A (en) * 1979-09-28 1981-07-21 Stump Lee K Occlusal instrument
US4530114A (en) * 1982-07-16 1985-07-23 Slobodan Tepic Total hip joint prostheses
US4846194A (en) * 1982-09-30 1989-07-11 Sabia Michael A Scoliosis measuring apparatus
DE3244819A1 (de) * 1982-12-03 1984-06-07 Ortopedia Gmbh, 2300 Kiel Vorrichtung zur externen fixierung von knochenfragmenten
FR2590159A1 (fr) * 1985-11-15 1987-05-22 Aubaniac Jean Appareillage pour la mise en place de protheses du genou notamment mono-compartimentaires internes et/ou externes, trochleo-condyliennes internes ou externes
DE3737993A1 (de) * 1987-11-09 1989-05-24 Gmt Medizinische Technik Gmbh Messvorrichtung fuer laengenmessungen an knochen
US4843720A (en) * 1988-06-06 1989-07-04 Kim Daniel S Y Dental measuring instrument
US4966600A (en) * 1989-01-26 1990-10-30 Songer Robert J Surgical securance method
US5148606A (en) * 1989-02-08 1992-09-22 Don Joy, Inc. Leg measuring device
FR2659224B1 (fr) * 1990-03-08 1992-06-19 Dore Jean Louis Repere chirurgical, et mesureur, notamment pour prothese de hanche, mettant en óoeuvre un tel repere.
JP2898341B2 (ja) * 1990-04-09 1999-05-31 株式会社八光電機製作所 膀胱造影検査器具
US5156162A (en) * 1991-08-29 1992-10-20 Gerhardt John J Scoliosis measurement instrument with midline leg member
US5318571A (en) * 1992-05-14 1994-06-07 Benson Gail M Method and apparatus for simplifying total hip arthroplasty
US5423828A (en) * 1992-05-14 1995-06-13 Bentwood Place, Inc. Method and apparatus for simplifying prosthetic joint replacements
SE9203579L (sv) * 1992-11-26 1994-05-27 Gustaf Gadelius Sätt att bestämma ett lårbens läge i förhållande till ett bäckenben i samband med en höftledsoperation

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4988349A (en) * 1987-01-21 1991-01-29 Orthofix S.R.L. Device for osteosynthesis
US4782842A (en) * 1987-02-02 1988-11-08 Fietti Jr Vincent G Arcuate fixator
US5122145A (en) * 1990-11-09 1992-06-16 Fishbane Bruce M Measuring device for use in total hip replacement

Non-Patent Citations (5)

* Cited by examiner, † Cited by third party
Title
N.M.J. MCGEE, F.R.C.S.: "A Single Method of Obtaining Equal Leg Length in Total Hip Arthroplasty", CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, vol. 194, 1985, pages 269 - 270, XP000607185
S.T. WOOLSON, M.D.: "A Method of Interoperative Limb Length Measurement in Total Hip Arthroplasty", CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, vol. 194, 1985, pages 207 - 210, XP000607184
See also references of EP0676932A4
W.E. KNIGHT, M.D.: "Accurate Determination of Leg Lengths During Total Hip Replacement", CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, vol. 123, 1977, pages 27 - 28, XP000607207
W.H. HARRIS, M.D.: "Revision Surgery for Failed Nonseptic Total Hip Arthroplasty", CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, vol. 106, 1975, pages 19 - 26

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994012109A1 (fr) * 1992-11-26 1994-06-09 Gustaf Gadelius Dispositif permettant de definir avec surete le positionnement reciproque du femur et de l'os iliaque en arthroplastie de la hanche
US5616147A (en) * 1992-11-26 1997-04-01 Meduse Scandinavia Ab Means to safely determine the mutual positions of a femur and an ilium in hip surgery
CN111189372A (zh) * 2020-03-05 2020-05-22 陕西斯坦特生物科技有限公司 股骨柄偏摆角目测检具及其检测方法

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US5603717A (en) 1997-02-18
US5755794A (en) 1998-05-26
CA2135753A1 (fr) 1993-11-25
US5318571A (en) 1994-06-07
EP0676932A4 (fr) 1996-12-18
EP0676932A1 (fr) 1995-10-18
JPH08508652A (ja) 1996-09-17

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